参芪调体方治疗多囊卵巢综合征胰岛素抵抗脾虚痰湿型的疗效及对炎症微环境状态的影响

Curative effect of Shenqi Tiaoti Formula on patients with polycystic ovarian syndrome-insulin resistance of spleen deficiency phlegm damp type and how to impact on inflammatory microenvironment

目的观察参芪调体方治疗多囊卵巢综合征胰岛素抵抗(PCOS-IR)脾虚痰湿型的疗效及对炎症微环境状态的影响。方法将96例PCOS-IR脾虚痰湿型患者按照随机数字表法分为2组,对照组48例予地屈孕酮片治疗,治疗组48例在对照组治疗基础上加用参芪调体方治疗。2组均治疗3个月经周期。比较2组治疗前后性激素指标[卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E_(2))和总睾酮(T)]、血糖指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)]、血清炎症因子[可溶性糖基化终产物受体(sRAGE)、白细胞介素8(IL-8)和肿瘤坏死因子α(TNF-α)]水平、卵巢体积、卵巢内部卵泡数目变化;观察2组不良反应发生情况。结果2组治疗后LH水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。2组治疗后FPG、FINS、HOMA-IR均较本组治疗前降低(P<0.05),治疗后治疗组FINS、HOMA-IR均低于对照组(P<0.05)。2组治疗后TC、TG、LDL-C均较本组治疗前降低(P<0.05)。2组治疗后血清sRAGE、IL-8、TNF-α水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗前后左、右侧卵巢体积及卵巢内部卵泡数目比较差异均无统计学意义(P>0.05)。2组治疗期间均未出现明显不良反应。结论参芪调体方治疗PCOS-IR脾虚痰湿型,可明显改善患者胰岛素抵抗(IR)和炎症微环境状态。

Objective To observe the curative effect of Shenqi Tiaoti Formula on patients with polycystic ovarian syndrome-insulin resistance(PCOS-IR)of spleen deficiency phlegm damp type and how to impact on inflammatory microenvironment(IME).Methods Totally 96 patients with PCOS-IR(spleen deficiency phlegm damp type)were randomly assigned into the treatment group(n=48)and the control group(n=48);in addition to dydrogesterone tablets,and the treatment group received Shenqi Tiaoti Formula based on control group.Treated for 3 menstrual cycles,the aim was to compare endocrine indexes(follicle stimulating hormone[FSH],luteinizing hormone[LH],estradiol[E_(2)],total testosterone[T]),blood glucose index(fasting plasma glucose[FPG],fasting insulin[FINS],Insulin resistance index[HOMA-IR]),blood lipid index(triglyceride[TG],total cholesterol[TC],high-density lipoprotein cholesterol[HDL-C]),low-density lipoprotein cholesterol[LDL-C],serum inflammatory factors(soluble Receptor for Advanced Glycation End Products[sRAGE],interleukin-8[IL-8],tumor necrosis factor-α[TNF-α]),ovarian volume,follicle number in ovary;the adverse reaction was assessed.Results After treatment,LH in groups was decreased(P<0.05),which was decreased in the treatment group compared with the control group(P<0.05);FPG,FINS,HOMA-IR in groups were decreased(P<0.05);FINS and HOMA-IR were decreased in comparison with the control group(P<0.05);TC,TG,LDL-C in groups were decreased(P<0.05);sRAGE,IL-8,TNF-αin groups were decreased(P<0.05),which in the treatment group were more common(P<0.05).None of the left and right ovarian volume and follicle number in ovary differed significantly between groups,and there were no significant adverse reactions.Conclusion For patients with PCOS-IR(spleen deficiency phlegm damp type),Shenqi Tiaoti Formula can significantly improve IR and IME.